SUTHERLAND CHAN

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Please take a moment to complete and submit the online application below.
An application fee of $75 is payable at this time by PayPal, Visa, MasterCard, American Express or Discover.

 

 

If you require assistance, contact Rubena Borg, Admissions and Social Media Coordinator at
416-924-1107 ext. 23 or by email.

Massage Therapy Diploma Program Application Form


* Required fields

Personal Information:

First Name*:
Last Name*:
Intended Enrollment Date*:

Contact Info:

Street*:
Apt #:
City*:
Prov./State*:
P.C./Zip*:
Telephone* Preferred:
Alternate Telephone:
Email address*:

In Case of Emergency, Please Contact:

Name:
Telephone* Preferred:
Alternate Telephone:

Educational Information:

i ) Secondary School:
City:
Prov./State:
Secondary Education Status:
Last Year of Attendance:
ii ) Post Secondary Institution:
City:
Prov./State:
Post Secondary Education Status:
Program:
Last year of Attendance:
Type of Degree/Diploma/Certificate Received:

* I declare that all of the information provided above and in any attached documents is accurate